miércoles, 22 de abril de 2015

Meditación Mindfulness para mejorar el sueño de los ancianos

Las tazas de té. Juan Gris

Desde el año pasado llevo adelante un proyecto que me ilusiona mucho, se trata de talleres de meditación Mindfulness con ancianos junto a Antonio Gamonal, psicólogo del Ayuntamiento de Villalba. Hemos terminado el primer ciclo con buenos resultados y estamos con el segundo. Uno de los aspectos que nos comenta alguno de los participantes es que duermen mejor por la noche cuando practican.

La meditación Midfulness (atención plena), es muy sencilla, se trata de dedicar un tiempo a mantener plena atención centrada en la respiración, el propio cuerpo, un pensamiento o un objeto. Algo que muchas tradiciones culturales llevan siglos proponiendo. El método MBSR se ha popularizado desde que Jon Kabat Zinn lo desarrollara para aliviar el stress de enfermos de cáncer hospitalizados. Hay mucho escrito sobre el tema, si tienes interés te dejo una lista de recursos aquí.

Hoy aporto una investigación que señala que el sueño de los ancianos mejora más con un programa de meditación basado en Mindfulness que con otro estandard de higiene del sueño.

Todo lo que sea buscar alternativas a las omiprentes pastillas me parece digno de valor. ¿Nos atreveremos los médicos a prescribir conciencia plena para ayudar a los ancianos?

Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep DisturbancesA Randomized Clinical Trial

David S. Black, PhD, MPH¹; Gillian A. O’Reilly, BS¹; Richard Olmstead, PhD²; Elizabeth C. Breen, PhD²; Michael R. Irwin, MD²

^{Importance
Sleep disturbances are most prevalent among older adults and
often go untreated. Treatment options for sleep disturbances remain
limited, and there is a need for community-accessible programs that can
improve sleep.

Objective
To determine the efficacy of a mind-body medicine
intervention, called mindfulness meditation, to promote sleep quality in
older adults with moderate sleep disturbances.

Design, Setting, and Participants
Randomized clinical trial with 2 parallel groups conducted
from January 1 to December 31, 2012, at a medical research center among
an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate
sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5).

Interventions
A standardized mindful awareness practices (MAPs) intervention
(n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was
randomized to participants, who received a 6-week intervention (2 hours
per week) with assigned homework.

Main Outcomes and Measures
The study was powered to detect between-group differences in
moderate sleep disturbance measured via the PSQI at postintervention.
Secondary outcomes pertained to sleep-related daytime impairment and
included validated measures of insomnia symptoms, depression, anxiety,
stress, and fatigue, as well as inflammatory signaling via nuclear
factor (NF)–κB.

Results
Using an intent-to-treat analysis, participants in the MAPs
group showed significant improvement relative to those in the SHE group
on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2
(1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE
intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1
(2.0) at postintervention. The between-group mean difference was 1.8
(95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed
significant improvement relative to the SHE group on secondary health
outcomes of insomnia symptoms, depression symptoms, fatigue
interference, and fatigue severity (P < .05 for all).
Between-group differences were not observed for anxiety, stress, or
NF-κB, although NF-κB concentrations significantly declined over time in
both groups (P < .05).

Conclusions and Relevance
The use of a community-accessible MAPs intervention resulted
in improvements in sleep quality at immediate postintervention, which
was superior to a highly structured SHE intervention. Formalized
mindfulness-based interventions have clinical importance by possibly
serving to remediate sleep problems among older adults in the short
term, and this effect appears to carry over into reducing sleep-related
daytime impairment that has implications for quality of life.}